Prognostic significance of echocardiographically defined mitral regurgitation early after acute myocardial infarction

Graham S. Hillis, Jacob E. Møller, Patricia Pellikka, Malcolm R. Bell, Grace C. Casaclang-Verzosa, Jae Kuen Oh

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: There are limited data regarding the clinical correlates and prognostic significance of echocardiographically defined mitral regurgitation (MR) early after acute myocardial infarction (MI). The current study addressed these issues. Methods: Seven hundred thirty-seven patients with acute MI who underwent transthoracic echocardiography with assessment of MR during their index admission were identified. Patients were followed up a median of 19 months later. The study end point was all-cause mortality. Results: The prevalence of MR increased with age. It was more common in women, in patients with non-ST-elevation MI, and in those with a history of diabetes, hypertension, prior MI, or previous revascularization. Patients with MR had worse left ventricular (LV) systolic function, more LV dilatation, and more clinical evidence of LV failure. Patients with moderate or severe MR had worse survival than those with no or mild MR (hazard ratio 2.3, 95% CI 1.6-3.2, P < .0001). Even mild MR predicted a higher mortality when compared with no MR (hazard ratio 1.7, 95% CI 1.2-2.4, P = .004). Mild or moderate MR was not independently predictive of outcome, although, in multivariable analyses, a trend toward worse survival was maintained in patients with severe MR. Conclusions: Mitral regurgitation, identified by echocardiography, early after acute MI predicts poorer survival after acute MI. However, if mild or moderate, it is not an independent prognostic indicator.

Original languageEnglish (US)
Pages (from-to)1268-1275
Number of pages8
JournalAmerican Heart Journal
Volume150
Issue number6
DOIs
StatePublished - Dec 2005

Fingerprint

Mitral Valve Insufficiency
Myocardial Infarction
Survival
Echocardiography
Mortality
Left Ventricular Function
Dilatation
Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prognostic significance of echocardiographically defined mitral regurgitation early after acute myocardial infarction. / Hillis, Graham S.; Møller, Jacob E.; Pellikka, Patricia; Bell, Malcolm R.; Casaclang-Verzosa, Grace C.; Oh, Jae Kuen.

In: American Heart Journal, Vol. 150, No. 6, 12.2005, p. 1268-1275.

Research output: Contribution to journalArticle

Hillis, Graham S. ; Møller, Jacob E. ; Pellikka, Patricia ; Bell, Malcolm R. ; Casaclang-Verzosa, Grace C. ; Oh, Jae Kuen. / Prognostic significance of echocardiographically defined mitral regurgitation early after acute myocardial infarction. In: American Heart Journal. 2005 ; Vol. 150, No. 6. pp. 1268-1275.
@article{7bda6ca3db7f4330a879d7a4c78406cb,
title = "Prognostic significance of echocardiographically defined mitral regurgitation early after acute myocardial infarction",
abstract = "Background: There are limited data regarding the clinical correlates and prognostic significance of echocardiographically defined mitral regurgitation (MR) early after acute myocardial infarction (MI). The current study addressed these issues. Methods: Seven hundred thirty-seven patients with acute MI who underwent transthoracic echocardiography with assessment of MR during their index admission were identified. Patients were followed up a median of 19 months later. The study end point was all-cause mortality. Results: The prevalence of MR increased with age. It was more common in women, in patients with non-ST-elevation MI, and in those with a history of diabetes, hypertension, prior MI, or previous revascularization. Patients with MR had worse left ventricular (LV) systolic function, more LV dilatation, and more clinical evidence of LV failure. Patients with moderate or severe MR had worse survival than those with no or mild MR (hazard ratio 2.3, 95{\%} CI 1.6-3.2, P < .0001). Even mild MR predicted a higher mortality when compared with no MR (hazard ratio 1.7, 95{\%} CI 1.2-2.4, P = .004). Mild or moderate MR was not independently predictive of outcome, although, in multivariable analyses, a trend toward worse survival was maintained in patients with severe MR. Conclusions: Mitral regurgitation, identified by echocardiography, early after acute MI predicts poorer survival after acute MI. However, if mild or moderate, it is not an independent prognostic indicator.",
author = "Hillis, {Graham S.} and M{\o}ller, {Jacob E.} and Patricia Pellikka and Bell, {Malcolm R.} and Casaclang-Verzosa, {Grace C.} and Oh, {Jae Kuen}",
year = "2005",
month = "12",
doi = "10.1016/j.ahj.2005.01.020",
language = "English (US)",
volume = "150",
pages = "1268--1275",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Prognostic significance of echocardiographically defined mitral regurgitation early after acute myocardial infarction

AU - Hillis, Graham S.

AU - Møller, Jacob E.

AU - Pellikka, Patricia

AU - Bell, Malcolm R.

AU - Casaclang-Verzosa, Grace C.

AU - Oh, Jae Kuen

PY - 2005/12

Y1 - 2005/12

N2 - Background: There are limited data regarding the clinical correlates and prognostic significance of echocardiographically defined mitral regurgitation (MR) early after acute myocardial infarction (MI). The current study addressed these issues. Methods: Seven hundred thirty-seven patients with acute MI who underwent transthoracic echocardiography with assessment of MR during their index admission were identified. Patients were followed up a median of 19 months later. The study end point was all-cause mortality. Results: The prevalence of MR increased with age. It was more common in women, in patients with non-ST-elevation MI, and in those with a history of diabetes, hypertension, prior MI, or previous revascularization. Patients with MR had worse left ventricular (LV) systolic function, more LV dilatation, and more clinical evidence of LV failure. Patients with moderate or severe MR had worse survival than those with no or mild MR (hazard ratio 2.3, 95% CI 1.6-3.2, P < .0001). Even mild MR predicted a higher mortality when compared with no MR (hazard ratio 1.7, 95% CI 1.2-2.4, P = .004). Mild or moderate MR was not independently predictive of outcome, although, in multivariable analyses, a trend toward worse survival was maintained in patients with severe MR. Conclusions: Mitral regurgitation, identified by echocardiography, early after acute MI predicts poorer survival after acute MI. However, if mild or moderate, it is not an independent prognostic indicator.

AB - Background: There are limited data regarding the clinical correlates and prognostic significance of echocardiographically defined mitral regurgitation (MR) early after acute myocardial infarction (MI). The current study addressed these issues. Methods: Seven hundred thirty-seven patients with acute MI who underwent transthoracic echocardiography with assessment of MR during their index admission were identified. Patients were followed up a median of 19 months later. The study end point was all-cause mortality. Results: The prevalence of MR increased with age. It was more common in women, in patients with non-ST-elevation MI, and in those with a history of diabetes, hypertension, prior MI, or previous revascularization. Patients with MR had worse left ventricular (LV) systolic function, more LV dilatation, and more clinical evidence of LV failure. Patients with moderate or severe MR had worse survival than those with no or mild MR (hazard ratio 2.3, 95% CI 1.6-3.2, P < .0001). Even mild MR predicted a higher mortality when compared with no MR (hazard ratio 1.7, 95% CI 1.2-2.4, P = .004). Mild or moderate MR was not independently predictive of outcome, although, in multivariable analyses, a trend toward worse survival was maintained in patients with severe MR. Conclusions: Mitral regurgitation, identified by echocardiography, early after acute MI predicts poorer survival after acute MI. However, if mild or moderate, it is not an independent prognostic indicator.

UR - http://www.scopus.com/inward/record.url?scp=28844483846&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=28844483846&partnerID=8YFLogxK

U2 - 10.1016/j.ahj.2005.01.020

DO - 10.1016/j.ahj.2005.01.020

M3 - Article

C2 - 16338270

AN - SCOPUS:28844483846

VL - 150

SP - 1268

EP - 1275

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 6

ER -